Sleep yourself better

October 15th, 2008

Although the first thought when the pain starts is to take Ultram, an equally urgent problem is the need to get a good night’s sleep. When you have a fairly constant level of pain, sleep is the first thing to suffer. Sleep does not come until you are too exhausted to care any more. To make the best recovery, you have to remain as positive as possible no matter what the world throws at you. Sleep is essential in this. If you’re walking around feeling like one of the living dead, you’ll feel less positive. That means taking drugs on top of the painkillers to help you sleep properly. Once you’ve established a better sleep routine, you can move on to the next step which is learning how to live your life within the new limits imposed by the pain. There will be a short-term role for sleeping pills to restore your strength of purpose. Now, with Ultram to help you through the first steps, it’s back to the drawing board to relearn how to move around with the least pain. So what are you waiting for? Start with Ultram now!

Doctors effort to cope

October 14th, 2008

It’s a sad fact of life that not enough doctors are coming through their training and entering general practice. This makes pain controversial. How much time does it take to distinguish between the genuine patients who need drugs like tramadol to get a better quality of life, and the drug abusers who want to get high or the dealers looking for product to sell on the streets.

The majority reject the longer hours and poor pay in favor of the high status and better paid work in hospitals. The result is towns and cities find themselves without primary healthcare, an accelerating problem as older doctors retire. Those practitioners who remain find time in short supply. When one patient walks through the door for a consultation, tens more wait outside. The best that they can do is to react to the symptoms described by their patients.

That means a quick prescription of tramadol instead of a more holistic approach. In a perfect world, the physician would look at the patient as a person losing mobility, under threat at work because the lifting and carrying is too difficult, friendships and marriage under pressure because this is all too stressful to manage. As it is, there is a single irony. The few doctors struggle to cope because so many people are in pain and need help.Patients come to doctors because they cannot cope.

What do the Chinese know that we don’t?

October 13th, 2008

One of the oldest medical treatments in the world is acupuncture. Whereas the West relies on painkillers like Ultram to get results, TCM adopts a holistic approach to heal the whole person. As one of the cornerstones of Traditional Chinese Medicine (TCM) practised for several thousand years, it works by stimulating specific points in the body using thin needles. It’s applied to relieve pain arising from a wide number of causes and it has the key advantage that, unlike western medications, it has no adverse side effects so long as it is delivered by a trained professional.

So far, the use of painkillers continues as the norm. But, as an alternative to or alongside physical therapy, there is an increasing acceptance of TCM by Americans. With the right practitioner to give you confidence, acupuncture is worth serious consideration.

In the U.S. the FDA regulates the needles and specifies the manufacturing standards to be applied to produce sterile, non-toxic products. In fact, millions of people in the U.S. use acupuncture and the FDA has almost no reports of problems other than those arising from the failure of sterilization procedures.

A new study shows insomnia is more persistent.

July 14th, 2008

Perhaps I am growing more cynical, but every time I see a new piece of research only lasting one or two years, I wonder why it stopped early. I suppose it is always a balancing act. If you have a specific hypothesis, evidence for or against should be apparent fairly quickly. Thus, if a company believes it has the new blockbuster drug, administering it to some brave volunteers should produce good results or lose credibility in months. Anyway, the longer a trial goes on, the more difficult it gets to distinguish between potential causes and their effects. So when one or two participants develop a heart condition or get depressed, is this a side effect of the medication under test or a coincidence? In many cases, the answer only emerges over time. But no-one is systematically collecting longitudinal data. This is very convenient for the manufacturers which might have to pull a medication from the market if adverse evidence emerged. This leaves a moral question: who puts a value on one or two lives lost when millions may be benefiting from the medication?

Anyway, I am inspired by a study published in this month’s Sleep which, unusually, collected evidence over twenty years. Long-term studies like this should be the norm when human health and lives are at risk. This research in Switzerland took a sample of just under six hundred young adults who were suffering from moderate to severe insomnia. This was a study of insomnia itself and not of any medication used to treat it.

The study shows that most of the group found the insomnia growing steadily more pronounced as the years passed. You might wonder why they were not all given ambien or an equivalent. The answer, of course, is that they were and to excellent short-term effect. But these powerful medications are only used in moderation and not over long periods of time. Further, the medications are not cures in the literal sense of the word. They merely give relief during which time those who suffer may attempt to relearn the art of sleep. Thus, even though ambien and other sleeping pills produced the promised sleep artificially, the majority of participants could not recapture the natural sleeping patterns of their youth. Curiously, women were more at risk of insomnia patterns stabilising and expanding. More worrying was that about 35% of those who had episodes of insomnia lasting more than two weeks subsequently suffered a major depressive disorder. The study concludes that insomnia is persistent and increases the risk of depressive conditions. This leaves me with three ad hoc conclusions:

  • once formed, the habit of not sleeping the usual seven or eight hours a night can be hard to break - only cognitive behavioural therapy or counselling can modify habits over the long term;
  • ambien can only be used to provide temporary relief because of the risk of dependence. But this use is necessary. Without ambien, a persistent insomniac’s health is damaged more quickly and more seriously; and
  • the disruption to sleep patterns is more closely linked to depression - as the medical profession is wont to say, they are comorbid conditions.

The final thought has to be that if you are unlucky enough to suffer from insomnia, take ambien as directed by your doctor and work intensively with a therapist or counsellor. The combination is the best chance of avoiding long-term problems.